TDH Update on Infections Associated with Epidural Steroid Injections

Friday, October 05, 2012 | 07:06am

NASHVILLE – Tennessee Health Commissioner John Dreyzehner, MD, MPH, has provided an update on the investigation of infections associated with epidural steroid injections. His statements from today’s media briefing are included below.

TDH will provide any new information on this investigation during the weekend in our online newsroom at http://news.tn.gov/taxonomy/term/30. The Centers for Disease Control and Prevention is providing information on the multi-state outbreak investigation at www.cdc.gov/HAI/outbreaks/meningitis.html.

Statement by Commissioner Dreyzehner October 5, 2012:

Good morning and thank you for being here with us, or participating by phone, as we provide information about the evolving investigation of some serious health issues in Tennessee.

While our investigation is part of an ongoing effort now encompassing 23 states, and continues to involve the CDC, the FDA and many other health and medical professionals, we’ll focus today on what is happening in Tennessee. It is imperative we continue our efforts to protect Tennesseans, doing all we can to safeguard lives. We will, in turn, depend on our partners with the CDC and FDA to keep you updated on national issues beyond our jurisdiction.

Before we get to other matters, I want to again extend our sympathy to the patients, families and friends of those impacted by this tragic situation. We continue our work knowing the toll has been very great for some, and that many are bearing physical or emotional pain. We will keep them in our thoughts and prayers.

Our focus is and will be on protection of Tennesseans, including case finding, investigation and public health support.

As of 11 a.m. today, the number of people in Tennessee identified with meningitis, abscess or stroke associated with this outbreak is 29. The number of deaths is unchanged at three.

Our team is continuing to provide support to other medical professionals in providing information to current patients and persons at risk for an infection. The work done thus far has been substantial, and we are fully committed to supporting our colleagues in providing additional accurate, timely information.

We will be assisting in providing public health support to patients who may be at risk by helping clinics with their patient contacts for appropriate follow-up. In light of uncertainty regarding incubation periods in some patients, we feel it is the prudent and appropriate step to continue to follow up regularly for some time with Tennessee’s at-risk population in this investigation.

It’s important to know the process of active case finding; that is, carefully studying patient information to look for signs of potential concern will continue. We appreciate your help in spreading the word to patients who had any epidural steroid injections between July 1 and Sept. 28 at the three centers using lots of material from the New England Compounding Center.

The symptoms people at risk should look out for, by priority, are: headache, worsening to severe; fever; stiff neck; unsteadiness, falling or difficulty walking; and back pain worse than their previous baseline. There are other symptoms, but these are the primary ones.

Following the CDC/FDA joint press conference yesterday, we issued another alert through the Tennessee Health Alert Network, or T-HAN, advising Tennessee clinicians to NOT USE ANY materials from the New England Compounding Center. While we have identified every facility that has the lots of the methylprednisolone acetate of concern in this investigation, to protect the safety of Tennesseans, we are directing clinicians to not use ANY material from NECC until further notice. We are working on identifying those facilities that received other NECC products.

Without certainty as to their other products’ integrity, we believe it is important these products not be used. We know the CDC and FDA are investigating other NECC products and we believe that is an important effort.

It is helpful to remember our continuing investigation has found no significant lapses in processes at any of the facilities in Tennessee that received material from NECC. These clinics and their staff are trying their level best to treat and improve the lives of patients who come to them in pain and we respect and support their efforts. Evidence indicates these clinics and clinicians had no way of knowing about the contamination at the time of the procedure. The evidence indicates this is a product issue.

Once we are able to have greater clarification, we’re hopeful these centers will return to normal operation because their work to relieve patient suffering is an important part of the health and medical community.

This weekend, investigative work and collaboration with our health and medical partners will continue. We know you will want updates on cases and deaths, and that will be available both Saturday and Sunday via our website: health.state.tn.us/.

We will not be providing additional details of our work this weekend, but we will have a teleconference media briefing Monday, Oct. 8, starting at 1 p.m. Central time, using the same call in number and passcode used this week.